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Nervous System > Red Eye and Adnexal Oncology > Flashcards

Red Eye and Adnexal Oncology Flashcards

1
Q

if there is non/ mild pain with pericorneal redness, minimal discharge and blurred vision what is the most likely diagnosis?

A

uveitis

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2
Q

describe symptoms and signs in bacterial conjunctivitis

A

> no pain/itch
peripheral/diffuse redness
yellow discharge
normal vision

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3
Q

what type of conjunctivitis would cause watery discharge?

A

viral conjunctivitis

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4
Q

describe what sort of discharge you would expect allergic conjunctivitis to produce

A

mucousy

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5
Q 
what would the most likely diagnosis me for:
> severe/boring pain
> sectoral/diffuse redness
> no discharge 
> normal vision
A

scleritis

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6
Q 
what would the most likely diagnosis be for:
> severe pain/headache
> pericorneal redness
> can be discharge
> loss of vision
A

acute glaucoma

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7
Q

describe symptoms that would be seen in keratitis/corneal ulcer

A

> severe pain/eye closing (?)
pericorneal redness
can be discharge
loss of vision

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8
Q

describe symptoms that would be seen in orbital cellulitis

A

> severe/periocular pain
no redness
can be discharge
normal vision

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9
Q

what does anterior uveitis affect?

A

the iris

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10
Q

what does intermediate uveitis affect?

A

the ciliary body and vitreous

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11
Q

what does posterior uveitis affect?

A

> retina
choroid
blood vessels

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12
Q

name the different types of uveitis

A

> anterior
intermediate
posterior
panuveitis

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13
Q

what systemic diseases in uveitis associated with?

A 
> ankylosing spondylitis
> behcets disease
> sarcoidosis
> wegners
> systemic lupus erythematosis
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14
Q

what infections are associated with uveitis?

A 
> TB
> syphilis
> toxoplasma
> herpes simplex
> lymes disease
> CMV
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15
Q

what are the treatment options for uveitis?

A

> topical anti-inflammatories
systemic steroids
systemic immunosuppressant’s in steroids not an option

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16
Q

what are the symptoms seen in acute angle glaucoma?

A

> severe pain
vomiting
fixed dilated pupil

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17
Q

what are the features of preseptal cellulitis?

A

> pain
redness
lid swelling
systemically unwell

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18
Q

what are some common causes for preseptal cellulitis?

A

> lid cyst

> insect bite

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19
Q

what are some of the features of orbital cellulitis?

A 
> pain
> redness
> lid swelling
> systemically unwell
> double vision
> conjunctivitis
> exophthalmos
> blurred vision
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20
Q

what are some common causes for orbital cellulitis?

A

> sinusitis
dental infections
haematological spread

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21
Q

name some inherited conditions that can have ophthalmic presentations

A 
> albinism
> ehlers-danlos
> marfans
> myotonic dystrophy
> neurofibromatosis
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22
Q

what ratio of orbital tumours are benign?

A

2/3

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23
Q

what cells are carcinomas derived from?

A

epithelial cells

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24
Q

what cell type are sarcomas derived from?

A

connective tissue

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25
Q

what cell type are lymphomas derived from?

A

haemopoietic cells maturing in the lymphatic tissue

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26
Q

what cell type do leukaemias develop from?

A

haemopoietic cells maturing in the blood

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27
Q

what are blastomas derived from?

A

cancers derived from immature precursor cells or embryonic cells

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28
Q

name some common benign eyelid tumours

A

> squamous cell papilloma
basal cell papilloma
melanocytic naevus

29
Q

name some rarer eyelid tumours

A 
> actinic keratosis
> pyogenic granuloma
> keratoacanthoma
> capillary haemangioma
> cavernous haemangioma
30
Q

what is the most common malignant eyelid tumour type?

A

basal cell carcinoma

31
Q

describe a squamous cell papilloma

A

> benign eyelid tumour
pedunculated or sessile
raspberry texture
usually viral

32
Q

what is the management for a squamous cell papilloma?

A

excision or laser ablation

33
Q

describe basal cell papilloma

A

> benign eyelid tumour
greasy, brown, flat and oval
unrelated to sun exposure

34
Q

what is the treatment for basal cell papilloma (seborrheic keratosis)?

A

excision

35
Q

what is melanocytic naevus composed of?

A

atypical melanocytes

36
Q

what colour and what level would a junctional melanocytic naevus be?

A

black and epidermis level

37
Q

what does the location of the melanocytes in melanocytic naevus influence?

A

clinical appearance and potential for malignant transformation

38
Q

what type of melanocytic naevus is brown and in the deep epidermis?

A

compound melanocytic naevus

39
Q

what type of melanocytic naevus is grey and in the papillary dermis?

A

intradermal

40
Q

what are some of the early signs of malignant transformation in melanocytic naevus?

A 
> asymmetry
> irregular border
> variegated colour
> diameter > 6mm
> growth
41
Q

what are some concerning features of melanocytic naevus suggesting nodular malignancy?

A

> elevated
firm to touch
growing

42
Q

describe a pyogenic granuloma

A 
> benign eyelid tumour
> fast growing
> highly vascularised granuloma
> may follow surgery, infection, trauma
> erythematous pedunculated mass
43
Q

what is the management for pyogenic granuloma?

A

excision

44
Q

describe actinic keratosis

A 
> common premalignant condition
> rare in eyelids
> flat
> scaly
> hyperkeratotic skin
> can form cutaneous horn
> related to sun exposure
45
Q

what is the treatment from actinic keratosis?

A

> excision

> medical treatment

46
Q

describe keratoacanthoma

A

> rare squamous cell carcinoma is situ
rapidly growing in other wise healthy skin
pink papule, hyperkeratonic crater

47
Q

what can cause keratoacanthoma?

A

> sun exposure

> immunosuppression

48
Q

what is the treatment for keratoacanthoma?

A

excision

49
Q

describe capillary haemangioma

A

> commonest tumour in infancy
predilection upper lip (with/without orbital extension)
astigmatism

50
Q

what is the management for capillary haemoangioma?

A

> beta blockers
intralesion steroid
surgery

51
Q

describe a cavernous haeangioma

A

> rare
congenital
well demarcated pink patch
darkens with age-does not involute

52
Q

what is the treatment for cavernous haemangioma?

A

laser

53
Q

what is the most commonest cancer world wide?

A

basal cell carcinoma

54
Q

what are basal cell carcinomas associated with?

A

pale skin and sun exposure

55
Q

what features are suggestive of a basal cell carcinoma?

A 
> slow growth over months
> non-pigmented, elevated, ulcerated
> pearly, rolled, irregular border
> telangiectasia
> lack of tenderness
56
Q

name the clinical subtypes of basal cells carcinomas

A

> nodular
ulcerative
morpheaform/infiltrative

57
Q

describe ulcerative basal cell carcinoma

A

> common
can progress from nodular
cycles of crusting and bleeding

58
Q

what is the management for basal cell carcinoma?

A

> standard excision
mohs surgery
non-surgical treatment

59
Q

describe the non-surgical treatment for basal cell carcinoma

A 
> topical
> chemotherapy
> cryotherapy
> radiotherapy
> photodynamic therapy
60
Q

describe squamous cell carcinoma

A

> malignant eye tumour
sun damaged skin
scaly surface over thick plaque
growth over weeks

61
Q

what is the management for squamous cell carcinoma?

A

excision

62
Q

describe sebaceous gland carcinoma

A 
> malignant eyelid carcinoma
> recurrent chalazion
> nodular indurated lid margin
> yellowish discolouration
> pagetoid spread along conjunctiva
63
Q

what is the management form sebaceous gland carcinoma?

A

excision

64
Q

what are the three types of cutaneous malignant melanoma?

A

> lentigo maliga
superficial spreading
nodular

65
Q

describe lentigo maligna CMM

A

> flat

> variably pigmented

66
Q

describe superficial spreading CMM

A

slightly raised pigmented plaque

67
Q

describe nodular CMM

A

vertically invasive

68
Q

name some benign orbital tumours

A

> capillary haemangioma
cavernous haemangioma
pleomorphic adenoma
optic nerve glioma

69
Q

name some malignant orbital tumours

A 
> lymphoma
> rhabdomyosarcoma
> lacrimal gland carcinoma
> osteocarcinoma
> liposarcoma
> primary melanoma

Nervous System (45 decks)

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